Study Shows Antibiotic Use Among Infants Can Be Reduced Without Adverse Effects

Antibiotic stewardship programs not only reduced the number of prescriptions, but also cut down the number of days infants were prescribed to take them.

Implementing an antibiotic reduction program in hospital neonatal intensive care units (NICUs) helps reduce the number and duration of antibiotic prescriptions among infants, according to the findings of a new study, which may have important implications for addressing the widespread overuse of the drugs and growing proliferation of antibiotic-resistant infections.

Hospital NICU stewardship programs helped to reduce new prescriptions by 19% and reduced the duration of antibiotic prescriptions by 20%, according to a report published on May 20 in the journal Pediatrics.

Antibiotics are one of the most frequently used drugs in NICUs. Broad spectrum antibiotics like Zithromax are commonly prescribed to protect infants at risk of infections. They are especially used to prevent sepsis; a severe infection that spreads quickly through the body, shuts down the organs and often leads to death.

Infant Antibiotic Overuse Concerns

Antibiotics are often prescribed to infants that are premature infants, have immature immune systems, or are more vulnerable to other infections. Additionally, if a mother experiences complications or infections during delivery, the infant may also be given antibiotics then as well.

However, medical experts have raised serious concerns about the overuse of antibiotics among infants, which has been linked to the creation of drug-resistant bacteria, or superbugs. A recent U.N. report warned the evolution of superbugs poses a serious threat to human health.

Research indicates that antibiotic overprescribing may increase colon cancer rates among young and older patients. The use of antibiotics in children is also linked to stomach problems and yeast infections. And the more antibiotics are used, the more strains of bacteria and diseases become immune to treatment with antibiotics.

In the new study, researchers from the University of Toronto and the University of Alberta reviewed previous studies focusing on antibiotic stewardship programs implemented in hospitals through May 2023.

The stewardship programs used various techniques, like doctor oversight, to reduce antibiotic use or reduce prescription duration. The review included data from 70 studies including more than 350,000 infants.

The data indicates that implementing antibiotic stewardship programs helped reduce new antibiotic prescriptions in NICUs by 19% on average, with rates ranging from 14% to 24% across various hospitals and programs. The programs reduced new prescriptions by 8% on average among NICUs and postnatal wards, ranging from 6% to 10% overall.

Stewardship programs also helped to reduce the overall duration of antibiotic use by an average pf 20%, ranging from 10% in some hospitals and up to 30% in others.

The programs helped to reduce the length of antibiotic therapy by 1.82 days on average but up to 2.65 days in some cases. Stewardship programs also helped to reduce the use of longer courses of antibiotic prescriptions that were greater than five days by 9%.

Researchers determined the study data showed that the programs helped to reduce antibiotic overuse and prescription duration, but they also helped to reduce restarting antibiotic courses. The findings indicated there was no increase in side effects or risk of death.

Researchers said, overall, the stewardship intervention programs were successful in helping to improve the safe and responsible use of antibiotics among infants in NICUs, which can translate to a long-term positive impact on reducing antibiotic-resistant bacteria.